Healthcare Provider Details

I. General information

NPI: 1366548893
Provider Name (Legal Business Name): H TERRY LEVINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10787 NALL AVE SUITE 200
OVERLAND PARK KS
66211-1375
US

IV. Provider business mailing address

10787 NALL AVE SUITE 200
OVERLAND PARK KS
66211-1375
US

V. Phone/Fax

Practice location:
  • Phone: 913-491-3300
  • Fax: 913-491-0904
Mailing address:
  • Phone: 913-491-3300
  • Fax: 913-491-0904

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number22968
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: